| Entity Name: | HUMANITARY MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Aug 2019 (5 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 18 Sep 2019 (5 years ago) |
| Document Number: | P19000061420 |
| FEI/EIN Number | 84-2655206 |
| Address: | 6607 N DALE MABRY HWY, TAMPA, FL, 33614, US |
| Mail Address: | 6607 N DALE MABRY HWY, TAMPA, FL, 33614, US |
| ZIP code: | 33614 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629612668 | 2019-11-02 | 2023-06-09 | 6607 N DALE MABRY HWY, TAMPA, FL, 336143985, US | 6607 N DALE MABRY HWY, TAMPA, FL, 336143985, US | |||||||||||||||
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| Phone | +1 813-499-1500 |
| Fax | 8134991499 |
Authorized person
| Name | MR. ELIECER GONZALEZ |
| Role | OWNER |
| Phone | 8134991500 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HUMANITARY MEDICAL CENTER | 2023 | 842655206 | 2024-07-10 | HUMANITARY MEDICAL CENTER | 99 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 621874769 |
| Plan administrator’s name | ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES |
| Plan administrator’s address | 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number | 8656701844 |
Signature of
| Role | Plan administrator |
| Date | 2024-07-10 |
| Name of individual signing | LISSI LYTLE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-09-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3052155759 |
| Plan sponsor’s address | 6607 N DALE MABRY HIGHWAY, TAMPA, FL, 33614 |
Plan administrator’s name and address
| Administrator’s EIN | 621874769 |
| Plan administrator’s name | ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES |
| Plan administrator’s address | 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number | 8656701844 |
Signature of
| Role | Plan administrator |
| Date | 2023-07-27 |
| Name of individual signing | TARA EVANS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-09-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3052155759 |
| Plan sponsor’s address | 6607 N DALE MABRY HIGHWAY, TAMPA, FL, 33614 |
Plan administrator’s name and address
| Administrator’s EIN | 621874769 |
| Plan administrator’s name | TAG RESOURCES LLC |
| Plan administrator’s address | 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number | 8656701844 |
Signature of
| Role | Plan administrator |
| Date | 2022-07-27 |
| Name of individual signing | TARA EVANS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-09-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3052155759 |
| Plan sponsor’s address | 6607 N DALE MABRY HIGHWAY, TAMPA, FL, 33614 |
Plan administrator’s name and address
| Administrator’s EIN | 621874769 |
| Plan administrator’s name | TAG RESOURCES LLC |
| Plan administrator’s address | 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number | 8656701844 |
Signature of
| Role | Plan administrator |
| Date | 2021-07-12 |
| Name of individual signing | PHIL TISUE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| CORPORATE CREATIONS NETWORK INC. | Agent |
| Name | Role | Address |
|---|---|---|
| GONZALEZ ELIECER | President | 6607 N DALE MABRY HWY, TAMPA, FL, 33614 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-04-28 | CORPORATE CREATIONS NETWORK, INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-28 | 801 US HIGHWAY 1, NORTH PALM BEACH, FL 33408 | No data |
| AMENDMENT | 2019-09-18 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-09-18 | 6607 N DALE MABRY HWY, TAMPA, FL 33614 | No data |
| CHANGE OF MAILING ADDRESS | 2019-09-18 | 6607 N DALE MABRY HWY, TAMPA, FL 33614 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| Reg. Agent Change | 2023-04-28 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-08-11 |
| ANNUAL REPORT | 2020-03-25 |
| Amendment | 2019-09-18 |
| Domestic Profit | 2019-08-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
